Wall Street Journal Examines How Costly Cancer Drugs Affect Physicians' Treatment Decisions

Main Category: Cancer / Oncology
Also Included In: Primary Care / General Practice
Article Date: 09 Jul 2008 - 12:00 PDT

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The Wall Street Journal on Tuesday examined how "hyperexpensive cancer drugs" are causing oncologists to go into debt and potentially interfering with treatment decisions. According to the Journal, a "new generation of cancer drugs," including Genentech's Avastin and ImClone Systems' Erbitux, are "transforming cancer care" by giving oncologists their first new treatment options in decades for "desperately ill patients." However, the price of the drugs -- up to $100,000 per year -- is pushing doctors into "new and nerve-racking territory: weighing costs alongside a drug's potential effectiveness," the Journal reports. Because cancer drugs are administered intravenously in a doctor's office, oncologists often must front the cost of the treatments and are "on the hook until patients or insurers pay the bill," the Journal reports. According to the Journal, it can take three months for Medicare or private insurers to reimburse physicians and often longer for patients to pay their cost sharing.

Pharmaceutical company officials say the high prices are required to recoup the amount they must spend to bring the drugs to market, the Journal reports. They also note that they provide millions of dollars of no-cost and discounted drugs and cost-sharing assistance for patients who are unable to pay.

Arthur Caplan, a bioethics professor at the University of Pennsylvania, said this is "one of the toughest issues in oncology," especially when drug prices can mean exchanging "family assets for the possibility of a few more months of life." A survey of 167 cancer doctors published last year in the Journal of Clinical Oncology found that 42% said they regularly raised the issue of cost when discussing treatment options with patients, 23% said costs influenced their treatment decisions and 16% said they choose not to discuss certain treatments when they know the cost would place strain on patients' resources.

The American Society of Clinical Oncology has named a task force to create a guide to help physicians to discuss cost with patients. The task force is expected to release a report this fall (Chase, Wall Street Journal, 7/8).

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